Get Wcb Intake Form - Cbi Health Group

Completing the Wcb Intake Form for the CBI Health Group is an essential step in accessing workers' compensation services. This guide provides clear and supportive instructions to help users fill out the form accurately and efficiently online.

Follow the steps to fill out the Wcb Intake Form online:

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Enter your personal information in the designated fields, including your name, date of birth, health card number, and contact details. Ensure all information is accurate and current.
3. Indicate if your injury was related to a work incident by selecting 'Yes' or 'No.' If you select 'Yes,' provide additional information regarding your case worker and claim number.
4. Detail your current work status, indicating if you are off work due to your injury or on modified duties. Include your last day worked if applicable.
5. Fill in the injury details, including the area of injury and the date it occurred, along with the names of your referring and family physicians.
6. Provide your private insurance information, including the insurance company name, policy number, covered percentage, and policy holder details.
7. Review the acknowledgment sections regarding the Workers’ Compensation coverage and your responsibility if costs are declined.
8. Sign and date the form to confirm the accuracy of the information provided and to comply with the necessary requirements.
9. Upon completion, save any changes made to the form. You may choose to download, print, or share the document as needed.

Complete your Wcb Intake Form online today to ensure timely processing of your workers' compensation claim.